Federal and state public health institutions have for years played a role in the delivery of genetic medicine. Dramatic increases in our understanding of the contributions of genetics to health are challenging these institutions to change their practices in public health genetics. The ability of public health actors to meet these challenges is shaped both by widely acclaimed successes in public health genetics, such as newborn screening, and by changes currently taking place in the role of public health more generally and by the history of eugenics and past missteps in public programs in genetics. This project will explore the breadth of current efforts to structure public health practice to respond to advances in genetics, analyzing these efforts for their consistency with existing public health law and policy and for their responsiveness to the lessons of history. The roles of public health institutions in reproductive genetic testing, state-run newborn screening programs, and predictive genetic testing will receive particular emphasis. The results of this analysis will be used to determine whether the new policies being adopted in public health genetics optimally meet the needs of the public, and if not, to suggest areas for improvement.